Common Breast Concerns

If you have concerns about your breast health, it is always recommended to consult with a healthcare professional for an accurate diagnosis and appropriate management.

Many women, at some point in their lives, will visit their doctor with a breast concern. Although breast issues can present in many ways, some common problems women may experience are discussed here.

Breast Pain & Discomfort

Breast pain and discomfort are common occurrences, and most women experience breast pain at some point in their lives. Breast pain can be localized to one breast or a specific area of the breast. It is important to note that breast pain is usually not associated with serious concerns. Sometimes the pain seems to radiate from the breast when it is really from a nearby anatomic location, such as the shoulder, neck, or chest wall (usually caused by arthritis). Conditions like costochondritis, inflammation of the cartilage that connects the ribs to the breastbone, can mimic breast-related pain. For this reason, the mammogram is often normal when breast pain is present.

During the menstrual cycle, hormonal changes can lead to breast discomfort. Hormones stimulate the glandular breast tissue, causing fluid accumulation and resulting in lumpiness, discomfort, or pain. Irregular menstrual cycles are commonly associated with breast pain and swelling as well.

Breast Lumps & Cysts

Breast lumps are often normal tissue composed of fibrous and fatty tissue, and they can feel lumpy due to changes in the menstrual cycle and weight fluctuations.

Cysts are one example of benign breast lumps. They are fluid-filled sacs and can cause a smooth, easily movable lump with pain or tenderness. Cysts may increase in size before the menstrual cycle and decrease afterward, and they can worsen with irregular menstrual cycles and approaching menopause.

Cysts may be challenging to differentiate from other lumps during self-exams or clinical exams, so breast imaging, including mammography and ultrasound, may be ordered by a doctor to evaluate them and ensure they are not caused by a more serious condition. 

Mammography is performed in the evaluation of lumps. The presence of cysts makes the breast tissue denser and more challenging to interpret with mammography. A breast ultrasound is often commonly used alongside other imaging techniques, like mammography, to aid in the evaluation and diagnosis of breast abnormalities, such as when a lump is found. It is a diagnostic tool to provide more information about the nature of the lump, such as its size, shape, and whether it is solid or fluid-filled.

Ultrasound can quickly evaluate if a lump is fluid-filled or solid. Some women may develop large cysts that can be painful, and the radiologist can drain these with a simple procedure to provide relief to the patient.

Fibrocystic condition is a non-cancerous condition that can cause breast cyst development. It is most likely to occur between the ages of 40-50 but can happen at any age. After menopause, the fibrocystic condition usually becomes less evident due to decreased hormone production, but hormone replacement therapy may cause cysts to persist or recur.

Discontinuing caffeine from sources like coffee, tea, cola, and chocolate may reduce tenderness, especially before your mammogram. Stopping caffeine will not eliminate fibrocystic breasts, but it may reduce some breast discomfort. Other factors associated with cyst development are irregular menstrual cycles, hormonal therapy, soy products, and increased stress.

Another common cause of a breast lump is a  fibroadenoma, a benign tumor more common in women under 30. Fibroadenomas are usually monitored by breast ultrasound in young women to establish that they remain stable over time or with mammography for women at the appropriate age for a yearly routine mammogram screening. Surgical excision may be considered if fibroadenomas significantly enlarge or cause symptoms such as pain.

ADDITIONAL RESOURCES (VIDEOS)